Phila. begins phasing in its strict new labeling law.

Menu Board at Dunkin Donuts

A sign at the Dunkin' Donuts shop in 30th Street Station now lists calories of menu items. The first phase of Philadelphia's new law covers chains with at least 15 other locations nationwide. APRIL SAUL / Philadelphia Inquirer Staff Photographer

Don Sapatkin of the Philadelphia Inquirer writes at that Swati Kapoor, 25, was about to order a double chocolate cake doughnut when she noticed something new on the rack at Dunkin’ Donuts.  A tag said 290 calories.  In an instant, she switched to a chocolate frosted doughnut (230 calories).

“To prevent obesity,” the skinny medical student explained, munching at a table in 30th Street Station.

Philadelphia begins phasing in enforcement of its strictest-in-the-nation menu-labeling law tomorrow. This first part, requiring chain restaurants to list calories on food tags and menu boards, is a relatively simple proposition that research shows can influence ordering habits.

A similar law will take effect in New Jersey next year, and dozens of such bills are pending around the country, including in Harrisburg.

What’s different in Philadelphia will become apparent on April 1, when restaurants with individual menus must list saturated fats, trans fats, carbohydrates, and sodium, in addition to calories, with every item.

No one really knows what will come of this broader experiment in attempted behavioral change.

“The majority of people, I believe, will see this as cumbersome and an overreaction and not necessary,” said George McKerrow Jr., president and chief executive officer of Ted’s Montana Grill, who anticipates having to expand the menu at his South Broad Street location from two pages to six.

Still, just two months after Ted’s added calories alone to its menu here, responding to a New York City requirement, McKerrow has noticed a small but measurable change in Philadelphia: “Some people have chosen to eat the healthier items more often.”

Restaurants initially fought all efforts to mandate labels on menus. As the movement spread, with dozens of variations proposed across the country, the industry switched its goal to uniformity: calories, yes; sodium, no.

It has won that fight everywhere except Philadelphia. City Council approved the measure in 2008, after viewing data that showed the impact of chronic diseases related to diet – diabetes is diagnosed in 13 percent of residents, high blood pressure in 36 percent – broken down by district.

Diabetics must manage their intake of carbohydrates (including sugar); too much sodium can raise blood pressure. Both are listed on the familiar nutrition-facts label on all prepackaged goods.

“But it is really hard for people, if they eat out, to know about the sodium content,” city Health Commissioner Donald Schwarz said.

At Olive Garden, for example, nothing on the dinner menu hints at a difference between linguine alla marinara (900 milligrams of sodium, according to its Web site) and pork Milanese (3,100 mg) – or notes that the Food and Drug Administration recommends less than 2,300 mg a day total, a line that must be added by April 1.

“It would make a difference,” said Nashikai Ianscoli, 57, of Center City, who has had to go on a diet to control her blood pressure. She grew up on a farm in the South where her mother got fresh vegetables by the bushel.

Much has changed since she was a child.

“Back in the 1970s, eating out was a special occasion. What people ate didn’t matter as much,” said Margo G. Wootan, nutrition-policy director at the Center for Science in the Public Interest.

Americans now get an estimated one-third of their calories from meals outside the home. And though FDA serving sizes haven’t changed, restaurant portions, especially fast food, have doubled or tripled. Skyrocketing obesity rates – one-third of Americans are obese, about the same as in Philadelphia – defied every big fix attempted.

In 2003, an influential study examined long-term trends and calculated that a difference of 100 calories a day, either ingested or spent, could tip the balance from national weight gain to weight loss. This, the researchers concluded in the journal Science, could be accomplished through small changes that the public would be more likely to embrace.

Wootan’s Washington center, meanwhile, had been pondering how to get people to eat better. At a conference, she recalled, dietitians were presented with hamburgers, onion rings, and other fare from sit-down restaurants and asked to estimate caloric content. Even with nutrition degrees, they were off by hundreds of calories, always on the low side.

Wootan developed a model menu-labeling law and started calling dozens of policymakers around the country: Maine (the first to introduce a bill), New York City (the first to pass it), Philadelphia (the fourth to implement it).

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